Coding Hypotension with Sepsis and Septic Shock

Hypotension is the medical term for low blood pressure. Merck Manual highlights the symptoms and signs of sepsis and septic shock. It is a common misconception that hypotension is a symptom of sepsis when it is a common symptom of septic shock, not sepsis.

According to Merck Manual, “symptoms and signs of sepsis can be subtle and often easily mistaken for manifestations of other disorders (e.g., delirium, primary cardiac dysfunction, pulmonary embolism), especially in postoperative patients. With sepsis, patients typically have fever, tachycardia, diaphoresis, and tachypnea; blood pressure remains normal. Other signs of the causative infection may be present. As sepsis worsens or septic shock develops, an early sign, particularly in older people or the very young, may be confusion or decreased alertness. Blood pressure decreases, yet the skin is paradoxically warm. Later, extremities become cool and pale, with peripheral cyanosis and mottling. Organ dysfunction causes additional symptoms and signs specific to the organ involved (e.g., oliguria, dyspnea).”